,,ii #aaeth ,,congress #b;d ,session ,s4 #bgbf ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,april #bc1 #bjah ,mr4 ,booker 7for himself1 ,mr4 ,nelson1 ,mr4 ,coons1 and ,mr4 ,carper7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to amend the ,public ,health ,service ,act to promote healthy eating and physical activity among children4 #a4 ,short title ,this ,act may be cited as the ,reducing ,obesity in ,youth ,act of #bjah4 #b4 ,findings and purposes 7a7 ,findings ,congress makes the following findings3 7#a7 ,research has shown that early childhood is an important time for developing dietary and physical activity behaviors that support health and well-being and may help prevent obesity4 7#b7 ,infants as young as #g months have shown eating patterns that are similar to older children and adults4 7#c7 ,for children under #a year of age1 promoting opportunities for movement 7such as reaching1 crawling1 and creeping7 may be the most effective way to increase physical activity and improve children's motor skills4 7#d7 ,children who are exposed to healthy foods early are more likely to prefer and eat healthy foods and to develop eating habits that promote healthy growth that can continue throughout childhood4 7#e7 ,healthy eating can improve a child's learning ability and potentially lead to higher academic performance1 along with his or her mental1 social1 and physical well-being and can contribute to increased self-esteem4 7#f7 ,a #bjaj study indicated that daily physical activity is not only essential for healthy weight maintenance1 but also for practicing and learning fundamental gross motor skills and socioemotional and cognitive skills4 ,furthermore1 when children have the opportunity for adequate physical activity1 they benefit physically1 psychologically and socially4 7#g7 ,nearly #bj percent 7#a in #e7 of #b-year-olds spend more than #b hours of a typical day watching television or videos4 7#h7 ,the ,journal of the ,american ,medical ,association ,pediatrics found that each incremental hour of watching television at age #b is associated with corresponding declines in school engagement1 math achievement1 and weekend physical activity1 and with increases in bullying by classmates1 consumption of soft drinks and snacks1 and ,,bmi at age #aj4 7#i7 ,about #bj percent of children between #b and #e years of age are overweight or obese4 7#aj7 ,a study published in the ,new ,england ,journal of ,medicine in #bjad found that a third of children who were overweight in kindergarten were obese by eighth grade4 ,almost every child who was very obese remained that way1 suggesting that efforts must start much earlier and focus more on the children at greatest risk4 7#aa7 ,a study published in the ,new ,england ,journal of ,medicine in #bjag estimates that over #ej percent of #b-year-olds today will be obese by #ce years of age4 7#ab7 ,a study examining the ,national ,health and ,nutrition ,examination ,survey published in #bjah found an increase in prevalence of childhood obesity in #bjae and #bjaf4 ,childhood obesity for children between #b and #e years of age increased from #i percent to #ad percent1 the highest increase since #aiii4 7#ac7 ,in #bjab1 three-fourths of ,united ,states preschool-aged children were in child care1 and most of their day was spent in sedentary activities4 7#ad7 ,center-based programs serve approximately #f1ihj1jjj children birth through age #e years but not yet in kindergarten1 making the early childhood care and education setting an important one for promoting healthful habits4 7#ae7 ,early care and education learning collaboratives in #i ,states have reached nearly #aef1jjj children and improved early childhood care and education provider practices for nutrition and physical activity4 7b7 ,purposes ,it is the purpose of this ,act to-- 7#a7 establish a program that will influence practices1 policies1 and environments in early care and education settings to support healthy eating1 physical activity1 and screen time reduction for children ages birth through #e2 7#b7 enhance the training and knowledge of early care and education providers on strategies for promoting healthy eating 7including early feeding best practices71 physical activity1 and screen time reduction in early care and education settings2 7#c7 monitor progress of healthy eating and physical activity promotion in early care and education settings2 and 7#d7 identify emerging1 and expand existing1 approaches to engaging families and parents of children ages birth to #e in healthy eating1 physical activity1 and screen time reduction4 #c4 ,healthy kids program ,title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bda et seq47 is amended by adding at the end the following3 ,w ,healthy ,kids ,program #cii,,oo4 ,definitions ,in this part3 7#a7 ,director ,the term ,director means the ,director of the ,centers for ,disease ,control and ,prevention4 7#b7 ,early care and education ,the term early care and education means programs and activities that serve children ages birth through #e years either through in-home or out-of-home settings1 including child care programs1 ,head ,start programs1 and pre-kindergarten programs4 7#c7 ,screen time reduction ,the term screen time reduction means policies or guidelines designed to reduce the daily amount of time that children spend watching or looking at digital monitors or displays1 including television sets1 computer monitors1 or hand-held gaming devices4 #cii,,oo-#a4 ,grants 7a7 ,in general ,the ,secretary1 in coordination with the ,centers for ,disease ,control and ,prevention and the ,administration for ,children and ,families shall1 subject to the availability of appropriations1 award #e-year competitive grants to eligible entities to assist in the development of healthier early care and education environments to improve healthy eating and physical activity among children ages birth through #e years in early care and education settings4 ,training provided under such grants shall be consistent with the best practices from existing health and wellness resources endorsed by the ,secretary1 in consultation with the ,national ,academy of ,medicine1 the ,office of ,child ,care and ,office of ,head ,start of the ,administration for ,children and ,families1 the ,division of ,nutrition1 ,physical ,activity1 and ,obesity of the ,centers for ,disease ,control and ,prevention1 the ,maternal and ,child ,health ,bureau of the ,health ,resources and ,services ,administration1 and the ,food and ,nutrition ,service of the ,department of ,agriculture4 7b7 ,eligibility ,to be eligible to receive a grant under subsection 7a71 an entity shall-- 7#a7 be-- 7,a7 a nonprofit organization with expertise in early childhood health and obesity prevention2 7,b7 an institution of higher education or research center that employs faculty with relevant expertise2 or 7,c7 a consortium of entities described in subparagraphs 7,a7 and 7,b7 that submit a single application to carry out activities under the grant jointly2 and 7#b7 submit to the ,director an application at such time1 in such manner1 and containing such information as the ,director may require4 7c7 ,use of funds 7#a7 ,identification of areas of opportunities and goals ,an entity that receives a grant under this section shall1 using ,department of ,health and ,human ,services guidance and tools 7such as the ,spectrum of ,opportunities for ,obesity ,prevention in the ,early ,care and ,education ,setting developed by the ,centers for ,disease ,control and ,prevention71 identify areas of opportunity and set goals and carry out activities to promote healthy eating1 physical activity1 and screen time reduction strategies among children ages birth through #e years in early care and education settings4 7#b7 ,activities ,an entity shall use amounts received under a grant under this section to carry out each of the following activities3 7,a7 ,provide training1 technical assistance1 and resources to implementing partners1 which may include ,states1 territories1 ,indian tribes1 municipalities1 and nonprofit organizations to integrate the promotion of healthy eating 7including early feeding best practices71 physical activity1 and screen time reduction into existing early care and education ,state programs and initiatives to create and spread sustainable change within the ,state or territory involved4 7,b7 ,work directly with implementing partners to create sustainable programs to train early care and education providers through train-the-trainer models1 learning collaboratives1 or other approaches approved by the ,secretary4 7,c7 ,enter into a contract with a nonprofit organization or other entity with relevant expertise that is approved by the ,secretary1 to evaluate the programs carried out under the grant1 including baseline1 process1 and outcome measurements4 7#c7 ,dissemination of best practices ,upon the conclusion of programs and activities carried out under the grants under this section1 the ,secretary shall disseminate to all appropriate agencies within the ,department of ,health and ,human ,services evidence1 best practices1 and lessons derived from the experiences of grantees with respect to reducing and preventing obesity and overweight among children ages birth through #e years in the early care and education settings4 ,such agencies shall encourage the adoption of such best practices4 7d7 ,preference 7#a7 ,grantees ,in awarding grants under this section1 the ,secretary shall give preference to eligible entities that demonstrate-- 7,a7 a history of working with early care and education providers and ,states in obesity prevention in the early care and education setting2 7,b7 a history of1 and capacity to1 leverage private dollars to amplify obesity prevention efforts in early care and education settings2 7,c7 a history of working successfully with an evaluator to determine program effectiveness2 7,d7 a history of1 and capacity to1 collaborate with the health sector on obesity prevention initiatives2 7,e7 a history of1 and capacity to1 spread and sustain health initiatives2 and 7,f7 the ability to conduct at least #c pilot programs to test innovative or evidence-informed approaches to engage families1 including families of children ages birth to #e years1 or to pursue other innovative approaches in the promotion of healthy eating and physical activity4 7#b7 ,implementing partners ,in selecting ,states1 territories1 ,indian tribes1 municipalities1 or nonprofit organizations under a grant under this section1 a grantee shall ensure that such partners-- 7,a7 serve populations that are racially1 ethnically1 socioeconomically1 and geographically diverse2 7,b7 represent a mix of rural and urban settings2 7,c7 have a varied level of existing infrastructure1 capacity1 and other programmatic initiatives to address obesity prevention in early care and education systems2 and 7,d7 possess expertise in early care and education or children's health and the ability to implement evidence-informed interventions to promote healthy eating1 physical activity1 and screen time reduction strategies in early care and education settings for children ages birth through #e years1 including strategies targeted to addressing the needs of children ages birth through #b years and strategies to engage parents in healthy eating and physical activity promotion4 7e7 ,tracking ,state progress ,the ,secretary shall use amounts appropriated under subsection 7g77#b7 to enter into contracts with1 or award grants to1 institutions of higher education1 nonprofit organizations1 or other entities with relevant monitoring and surveillance expertise that are approved by the ,secretary1 to track ,state progress in obesity prevention policies and practices of early care and education programs through a sentinel set of ,states4 7f7 ,report to ,congress ,not later than #ab months after the completion of the programs and activities funded under grants awarded under this section1 the ,secretary shall submit to ,congress a report concerning an evaluation of the results of such programs and activities and sentinel surveillance1 including recommendations on how lessons learned from such programs can be incorporated into future guidance documents developed and provided by the ,secretary or ,director and other ,federal agencies as appropriate4 7g7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section-- 7#a7 #d1jjj1jjj for each of fiscal years #bjai through #bjbc2 and 7#b7 #a1gjj1jjj for fiscal year #bjai1 to be used to track ,state progress in obesity prevention policies and practices of early care and education programs in a sentinel set of ,states as provided for in subsection 7e74 4